连续性血液净化治疗对全身炎症反应综合征及脓毒血症患者一氧化氮合酶和降钙素原的影响分析

Influence of Continuous Blood Purification Therapy on Nitric Oxide Synthase and Procalcitonin in Patients with Systemic Inflammatory Response Syndrome and Sepsis

目的探讨连续性血液净化治疗全身炎症反应综合征(SIRS)及脓毒血症患者的临床效果。方法选取长江航运总医院2019年1月至2021年12月收治的73例SIRS及脓毒血症患者为研究对象,按不同治疗方法分为两组,对照组33例,采用常规治疗;观察组40例,基于对照组采用连续性血液净化;记录两组患者预后结局,比较两组患者治疗前后的炎症水平:降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、一氧化氮合酶(NOS)、血流动力学变化。结果两组治疗后28 d病死率比较,差异无统计学意义(P>0.05)。观察组多器官功能障碍(MODS)发生率12.50%低于对照组的36.36%,SIRS消退时间、住ICU时间短于对照组(P<0.05)。观察组治疗后血乳酸水平、急性生理学及慢性健康状况评分系统Ⅱ(APACHEⅡ)评分低于对照组,PCT、NOS、hs-CRP水平低于对照组,血流动力学改善程度高于对照组(P<0.05)。结论连续性血液净化治疗SIRS及脓毒血症患者,通过降低患者PCT、NOS水平,而改善患者疾病预后结局。

Objective To investigate the clinical effect of continuous blood purification in the treatment of patients with systemic inflammatory response syndrome and sepsis.Methods A total of 73 patients with systemic inflammatory response syndrome(SIRS)and sepsis admitted to Changjiang Shipping General Hospital from January 2019 to December 2021 were selected and divided into two groups according to different treatment methods.40 patients in the observation group were treated with continuous blood purification based on the control group;the prognosis of the two groups of patients was recorded,and the inflammatory levels before and after treatment were compared between the two groups:procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),nitric oxide synthase(NOS),hemodynamic changes.Results There was no significant difference in the 28-day mortality rate after treatment between the two groups(P>0.05),the incidence of multiple organ dysfunction(MODS)in the observation group was 12.50%lower than that in the control group(36.36%),and the SIRS subsidence time and ICU stay were shorter than those in the control group(P<0.05).After treatment,the blood lactate level,APACHE II score of the observation group were lower than those of the control group,the levels of PCT,NOS and hs-CRP were lower than those of the control group,and the degree of hemodynamic improvement was higher than that of the control group(P<0.05).Conclusion Continuous blood purification in the treatment of patients with systemic inflammatory response syndrome and sepsis can improve the prognosis of patients by reducing the levels of PCT and NOS.